She was the vision of youth and at 31 years old, Jackie Kennedy was the third youngest First Lady in history. She played tennis, loved speed walking for miles on end, swam like a pro and enjoyed waterskiing to keep her thighs trim.
So, on the night of January 20, 1961, when just eight weeks after she had been rushed into Georgetown University Hospital for emergency cesarian surgery to give birth to her son, Jacqueline Kennedy appeared in her white cape and gown at the Inaugural Balls, the world looked upon her as the vision of of beaming health. In truth, she was anything but that.
The press had also begun to depict her as “mysterious” and “elusive” because she failed to appear at many of the large, crowded events held before the Inauguration other than the Inaugural Concert and the Inaugural Gala.
After the Inaugural ceremony and parade, she vanished even from the gathered members of her paternal and maternal family and those of her husband’s, during s White House Reception held before the Inaugural Ball.
When the time came for her to join the new President and exit through the North Portico, still and motion picture cameras were fixated on her serene face, as she seemed to float out the door.
And while she appeared at the first few Inaugural Balls, she just as soon disappeared for the rest of the night, returning to the White House while John F. Kennedy continued on to the other balls.
In fact, she was suffering what she later described as clinical exhaustion. Once she had returned to the executive mansion, she admitted that she entirely “collapsed.” It had only been the administration of a narcotic drug by the president’s doctor, Janet Travell, that she had been able to muster enough strength to appear at the balls.
This fact was something the press would never learn during her time in the White House. It was only after she had left and made casual reference to the fact that she got through Inauguration Day only by using dexedrine, a frequently prescribed amphetamine medication intended to infuse “energy” into the system, that the world learned the truth.
The only occasions when the White House released any information on the First Lady was when she failed to show up at a public appearance. The fact that she did indeed suffer with frequent sinusitis was often given as the reason for her absence. That is, until the day when she showed up instead at a theater performance in New York.
It was only towards the end of her tenure, when Jackie Kennedy again gave birth that the world would learn the medical details about this most private of First Ladies. Every detail was reported because the press corps was closely following, down to the minute the premature birth and sudden death of her baby, Patrick, in August of 1963.
Two months later, as she endured the aftermath of her husband’s assassination, there was no mention of any medication she may have needed or requested or turned down then or in the days that followed. The old sense of propriety about keeping the matter of a woman’s health private, especially given the terrible circumstances, was again employed for the president’s widow.
Like millions of women who believed the advertising campaigns that promoted cigarette smoking as a way to stay calm and keep thin, Jackie Kennedy was a heavy cigarette smoker but White House photographers were ordered to never snap her in the act of puffing and if, by accident, they captured her doing so the pictures were banned from public release.
More remarkably, the commercial photographers who regularly captured her on film as she went about her private business adhered to an unwritten rule of not publishing images of the First Lady smoking.
A decade later, after the Surgeon General warnings about the dangers of cigarette smoking, this same unwritten rule the press had applied for Jackie Kennedy continued for Pat Nixon.
Although there were not even any known images showing this First Lady smoking, it was a fact known to several reporters who followed her closely. Yet Mrs. Nixon’s press office steadfastly insisted that she did not smoke cigarettes. Some twenty years after her time in the White House, Mrs. Nixon died of lung cancer.
In the contemporary world of social and digital media, every possible detail is reported about anything pertaining to the President and has come to be considered fair game for public dissemination, including medical information. Should we also expect that the health of our First Ladies be made public?
Since the incumbency of Pat Nixon as First Lady in the 1970s, matters of health care, preventative health measures, public awareness about early warning signs of specific illnesses and those physical problems which particularly affect American women have become among primary issues First Ladies since then have sought to address in various forums.
Today, there are good arguments both that the public has a right to know the details about the First Lady’s health or that disclosure of such sensitive matters is a prerogative of the individual in question.
Outside of this one can find no greater example of the dramatically positive affect of full disclosure regarding a First Lady’s health than the 1974 breast cancer and mastectomy of Betty Ford.
Previous to this incident, discomfort in the discussion of breast cancer prevention and detection had kept the matter one that remained largely verboten in the general public discussion and news media.
Quite literally overnight, that societal norm shifted because of Mrs. Ford’s conscious decision to permit full public disclosure; as a result untold hundreds of thousands of lives were likely saved as not only American but non-American women sought out the necessary medical procedures ensuring early detection.
This new sense of freedom about discussing the issue was greatly furthered when Betty Ford decided to assume the role of a national spokesperson about it, doing all she could to help women and their families more comfortable about discussing breast cancer.
Some one dozen years later, another First Lady discovered she had breast cancer and sought immediate treatment of it.
In line with the detailed disclosures made about President Reagan’s health challenges, when Nancy Reagan considered her highly committed schedule in the months ahead, the First Lady opted to have a complete mastectomy, which disfigured the body, rather than a partial mastectomy and the weeks of chemotherapy that would have to follow.
She was lobbied heavily against this by advocates for the latter treatment, but decided against it because the time would have required her to shift focus from her support to the President at a time when she felt he needed her most.
Thus, with a First Lady deciding to fully go public with what was still, ultimately, a personal decision, there inevitably came criticism of her choice.
In 1989, Barbara Bush followed the precedent set by Betty Ford and Nancy Reagan, permitting full public disclosure of her diagnosis of Grave’s Disease, a hyperactive thyroid condition, following her detection that her eyesight was changing and that her eyes appeared to bulge.
Her doing so helped raise public awareness of this condition which often went undetected and led to other complications.
Modernity, interestingly, is not a factor in how fully a First Lady might chose to publicly disclose her health issues.
Nearly twenty years after Barbara Bush chose to disclose her thyroid condition, however, her daughter-in-law Laura Bush did not permit the news that she had a squamous cell carcinoma tumor, commonly known as “skin cancer,” removed from her right shin in November 2006 until five weeks after the surgery.
“It’s no big deal,” she said, explaining her decision, “and we knew it was no big deal at the time.”
No matter how many examples may have been set before her, history shows that when it comes to disclosing their health issues, First Ladies will do as they usually do on matters involving their public lives: what is right for them and not what was right for those before them.